Thanks, Kathleen Bruce, for your post on this.
I meet a lot of health professionals who uphold the notion of the Perfectly
Virtuous mother as the only acceptable ideal for breastfeeding, and who are
very bothered by mothers who breastfeed and continue to smoke and drink.
(None of them are bothered that the mothers are probably sexually active as
well, oddly enough, nor have I heard anyone express concern that they may be
playing the lottery or betting.)  I am bothered by women smoking and
drinking to excess whether or not they are mothers, AND I still want babies
to get their mothers' milk.

I inform audiences of the pharmacokinetics of alcohol in breastmilk.  And I
say what my opinion is: that whatever our concerns about parenting and
alcohol, the LAST thing we should recommend in 99% of cases is to avoid
breastfeeding.  There is also recent research on smoking in new mothers
showing that as long as they breastfed, they kept their smoking to a
minimum, so the incentive to breastfeed could lead to reduced alcohol
consumption.

Recently I was asked 'What about when you can smell the alcohol in a sample
of expressed milk?'.  This had happened in a NICU, where the baby was being
treated for prematurity and had a diagnosis of FAS.  The mother was bombed,
and don't ask me how she managed to use a pump or have a MER.  The point is
this is not the norm, and for me it proves the rule.  In that case there
were many other pressing concerns about that mother's ability to care for
herself, let alone her baby.  Deal with the real concerns, not with
primitive notions of sinfulness and virtue, purity and pollution.

Just my contaminated 30 ml worth!
Rachel Myr
Kristiansand, Norway

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